Weight recidivism post-bariatric surgery: a systematic review.

Area of Science:

• Bariatric surgery
• Obesity management
• Metabolic and endocrine disorders

Background:

• Obesity is a global epidemic requiring effective interventions.
• Bariatric surgery is the most effective treatment for severe obesity, improving comorbidities and life expectancy.
• Weight regain (recidivism) post-bariatric surgery presents significant medical, societal, and economic challenges.

Purpose of the Study:

• To systematically review the literature on the incidence and causative factors of weight regain after bariatric surgery.
• To understand predictors for weight regain and inform treatment strategies for patients experiencing weight recidivism.

Main Methods:

• A comprehensive electronic literature search was conducted across Medline, Embase, Cochrane Library, and PubMed (January 1950 – December 2012).
• Initial screening of 2,204 titles, followed by abstract review (1,437) and exclusion (1,421).
• Sixteen studies (7 case series, 5 surveys, 4 non-randomized controlled trials) involving 4,864 patients were included.

Main Results:

• Weight regain post-bariatric surgery is multi-factorial, involving overlapping patient-specific and operation-specific factors.
• Patient-specific factors include psychiatric issues, physical inactivity, endocrinopathies/metabolic conditions, and dietary non-compliance.
• Operation-specific factors and duration of follow-up also influence weight regain.

Conclusions:

• Weight regain following bariatric surgery is complex, stemming from both patient-related and procedure-related elements.
• A systematic patient assessment addressing dietary, psychological, medical, and surgical factors is crucial for managing post-surgical weight regain.
• Further research is needed to predict and effectively treat weight recidivism after bariatric interventions.